| Objective: To compare the efficacy of AP、PA lag screws and posterior plate in the treatment of Haraguchi type posterior Ⅰ malleolar fractures.Methods: From October 2016 to October 2018,we retrospectively analysised clinical data of 60 patients with posterior ankle fracture who received surgical treatment in the department of orthopaedics of the first affiliated hospital of wannan medical college.According to the different internal fixation methods of posterior malleolus fixation,the patients were divided into antero-posterior lag screw group(AP group)(20 cases),posterior-antero lag screw group(PA group)(20 cases)and support plate group(20 cases).Results: 1.The operative time of the three groups was different(P<0.05),and the AP group < PA group < support plate group;2.The difference of excellent and good rate of postoperative reduction quality burrwell-charnley radiological score between the PA group and the support plate group and the AP group was statistically significant(P<0.05),and the excellent and good rate of postoperative radiological score between the PA group and the support plate group was greater than that of the AP group.There was no significant difference in excellent and good rates of postoperative radiological scores between the PA group and the support plate group(P>0.05).3.The differences in fracture healing time between the three groups were statistically significant(P<0.05),AP group(14.31±0.19 weeks),PA group(15.76±0.31 weeks),and plate group(12.07±0.24 weeks),support plate group < AP group < PA group.4.There were statistically significant differences in the first weight-loading exercise time between the three groups(P<0.05).AP group(12.04±0.27 weeks),PA group(11.12±0.17 weeks),the support plate group(8.49±0.16 weeks),AP group < support plate group < PA group.5.The AOFAS scores of ankle joints in the support plate group were significantly different from those in the AP and PA groups 3 months after surgery.The difference was statistically significant(P<0.05).AP group(81.21±0.16),PA group(83.58±0.11),support plate group(86.15±0.16).Plate group > PA group > AP group.6.At the last follow-up,there was no significant difference in the AOFAS score of the ankle joint 12 months after surgery between the three groups(P>0.05).AP group(91.25±1.22),PA group(91.34±1.53),support plate group(91.48±1.07).Conclusion: There were significant differences in AOFAS scores between the 3 months after surgery.Plate group> PA group > AP group;There was no significant difference in AOFAS scores of ankle joints between the three groups at the 12 months after surgery.The postoperative reset quality of PA screws and support plates was higher than that of AP screws;The healing time of posterior malleolus fracture in the three groups was different,and the support plate group < AP group < PA group;There were statistically significant differences in the first weight-loading exercise time between the three groups,the support plate group was significantly less than the AP group and the PA group. |
